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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Validation of Patellar Stabilization Surgical Algorithm Based on Congruence
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Validation of Patellar Stabilization Surgical Algorithm Based on Congruence

机译：基于同余的of骨稳定手术算法验证

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Background: Multiple algorithms exist for proximal and/or distal stabilisation surgery for patellar instability with no consensus in the literature. Aim: To validate our surgical algorithm based on patellofemoral congruence for patellar instability. Algorithm: Once patellar stabilization surgery is clinically indicated, we determine patellofemoral congruence abnormality based on quadriceps active CT and intraoperative arthroscopic assessment. Arthroscopic lateral release is carried out if indicated. For patients with minimal incongruence post lateral release, MPFL reconstruction alone (MPFL group) is performed, and we perform tibial tubercle transfer and MPFL reconstruction (TTT group) for significant incongruence Methods: Retrospective study with prospective follow up of patients operated on between 2008 and 2015. We excluded patients with skeletal immaturity, previous patellofemoral surgery, and distalisation of tibial tubercle. Chart review, pre and post operative quadriceps active CT, Kujala score, and patient’s subjective stability analysed. Results: 98 patients were reviewed with mean follow up 37 weeks. 14 patients had MPFL alone. Recurrence of instability occurred in 4% of patients, all in TTT group. Reoperation rate was 19%, almost all in TTT group, with removal of hardware being the most common reason. There was no significant difference in TTTG between the two groups on pre operative CT measurement. Conclusion: Patellar stabilization surgical algorithm based on congruence is valid in preventing further instability. Reoperation rate is high due to majority of patients receiving TTT procedure.
机译：背景：在algorithms骨不稳的近端和/或远端稳定手术中存在多种算法，但文献中尚无共识。目的：验证基于validate股融合的oral骨不稳手术算法。算法：一旦临床表明pa骨稳定手术，我们将基于股四头肌主动CT和术中关节镜评估确定determine股融合异常。如果有指示，则进行关节镜侧向释放。对于侧向释放后具有最小一致性的患者，仅进行MPFL重建（MPFL组），然后进行胫骨结节转移和MPFL重建（TTT组）以实现显着性一致性。 2015年。我们排除了骨骼发育不全，previous骨股骨手术和胫骨结节远端化的患者。进行图表检查，分析股四头肌手术前后的动态CT，Kujala评分以及患者的主观稳定性。结果：98例患者进行了平均随访37周。 14名患者单独患有MPFL。 TTT组中有4％的患者发生不稳定性复发。 TTT组的再手术率为19％，几乎全部如此，最常见的原因是拆除硬件。术前CT测量两组间TTTG无明显差异。结论：基于一致性的Pat骨稳定手术算法可有效防止进一步的不稳定。由于大多数接受TTT手术的患者，再次手术率很高。

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